中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2015年
4期
537-538,541
,共3页
盖延红%栾晓东%朱为勇%徐丹
蓋延紅%欒曉東%硃為勇%徐丹
개연홍%란효동%주위용%서단
顽固性高血压%螺内酯%血压%收缩压%年龄
頑固性高血壓%螺內酯%血壓%收縮壓%年齡
완고성고혈압%라내지%혈압%수축압%년령
Refractory hypertension%Spironolactone%Blood pressure%Systolic blood pressure%Age
目的:探讨螺内酯在不同年龄难治性高血压患者的疗效差别。方法选择2012年9月~2014年5月于青岛大学医学院第二附属医院心内科门诊诊治的难治性高血压患者共144例,其中男性75例,女性69例,年龄53~78岁,平均(615±97)岁。根据就诊顺序,使用随机数字表,分为螺内酯组(71例)和对照组(73例)。按照年龄分为≤60岁组(72例)和>60岁组(72例)。螺内酯组在原有治疗的基础上加用螺内酯,对照组加用安慰剂,连续给药12周。动态血压监测仪进行24 h动态血压监测,仪器测定后自动计算白天平均收缩压、舒张压、脉压;夜间平均收缩压、舒张压、脉压;24 h平均收缩压、舒张压和脉压。结果与(≤60岁)螺内酯组比较,(>60岁)螺内酯组白天平均收缩压、夜间平均收缩压、24 h平均收缩压、诊室收缩压、夜间平均脉压、24 h平均脉压下降幅度更高,差异有统计学意义(P均<0.05)。对年龄>60岁的患者,螺内酯组较安慰剂组白天平均收缩压、夜间平均收缩压、24 h平均收缩压、诊室收缩压、白天平均脉压、夜间平均脉压、24 h平均脉压下降幅度更高,差异有统计学意义(P均<0.05)。结论螺内酯能够降低难治性高血压患者(>60岁)的收缩压。
目的:探討螺內酯在不同年齡難治性高血壓患者的療效差彆。方法選擇2012年9月~2014年5月于青島大學醫學院第二附屬醫院心內科門診診治的難治性高血壓患者共144例,其中男性75例,女性69例,年齡53~78歲,平均(615±97)歲。根據就診順序,使用隨機數字錶,分為螺內酯組(71例)和對照組(73例)。按照年齡分為≤60歲組(72例)和>60歲組(72例)。螺內酯組在原有治療的基礎上加用螺內酯,對照組加用安慰劑,連續給藥12週。動態血壓鑑測儀進行24 h動態血壓鑑測,儀器測定後自動計算白天平均收縮壓、舒張壓、脈壓;夜間平均收縮壓、舒張壓、脈壓;24 h平均收縮壓、舒張壓和脈壓。結果與(≤60歲)螺內酯組比較,(>60歲)螺內酯組白天平均收縮壓、夜間平均收縮壓、24 h平均收縮壓、診室收縮壓、夜間平均脈壓、24 h平均脈壓下降幅度更高,差異有統計學意義(P均<0.05)。對年齡>60歲的患者,螺內酯組較安慰劑組白天平均收縮壓、夜間平均收縮壓、24 h平均收縮壓、診室收縮壓、白天平均脈壓、夜間平均脈壓、24 h平均脈壓下降幅度更高,差異有統計學意義(P均<0.05)。結論螺內酯能夠降低難治性高血壓患者(>60歲)的收縮壓。
목적:탐토라내지재불동년령난치성고혈압환자적료효차별。방법선택2012년9월~2014년5월우청도대학의학원제이부속의원심내과문진진치적난치성고혈압환자공144례,기중남성75례,녀성69례,년령53~78세,평균(615±97)세。근거취진순서,사용수궤수자표,분위라내지조(71례)화대조조(73례)。안조년령분위≤60세조(72례)화>60세조(72례)。라내지조재원유치료적기출상가용라내지,대조조가용안위제,련속급약12주。동태혈압감측의진행24 h동태혈압감측,의기측정후자동계산백천평균수축압、서장압、맥압;야간평균수축압、서장압、맥압;24 h평균수축압、서장압화맥압。결과여(≤60세)라내지조비교,(>60세)라내지조백천평균수축압、야간평균수축압、24 h평균수축압、진실수축압、야간평균맥압、24 h평균맥압하강폭도경고,차이유통계학의의(P균<0.05)。대년령>60세적환자,라내지조교안위제조백천평균수축압、야간평균수축압、24 h평균수축압、진실수축압、백천평균맥압、야간평균맥압、24 h평균맥압하강폭도경고,차이유통계학의의(P균<0.05)。결론라내지능구강저난치성고혈압환자(>60세)적수축압。
Objective To discuss the difference in curative effect of spironolactone in patients with refractory hypertension at different age stages. Methods The patients (n=144, male 75, female 69, aged from 53 to 78 and average age=615±97) were chosen from Sept. 2012 to May 2014. The patients were divided, according to registration order, into spironolactone group (n=71) and control group (n=73) by using random digital table, and according to age, into age≤60 group (n=72) and age>60 group (n=72). The spironolactone group was additionally given spironolactone and control group was additionally given placebo on the base of original treatment for 12 w. The blood pressure monitor was used for monitoring 24-h ambulatory blood pressure, and after monitoring daytime average systolic blood pressure (SBP), daytime average diastolic blood pressure (DBP) and daytime average pulse pressure (PP), nighttime average SBP, nighttime average DBP and nighttime average PP, and 24-h average SBP, 24-h average DBP and 24-h average PP were calculated. Results The daytime average SBP, nighttime average SBP, 24-h average SBP, clinic SBP, nighttime average PP and 24-h average PP decreased significantly in age>60 group compared with age≤60 group (all P<0.05). For patients aged>60, daytime average SBP, nighttime average SBP, 24-h average SBP, clinic SBP, daytime average PP, nighttime average PP and 24-h average PP decreased significantly in spironolactone group compared with control group (all P<0.05). Conclusion Spironolactone can reduce SBP in patients with refractory hypertension.